Stacey Lynn Shaw, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

20127 Issued in SC

Practice address

607 Briarwood Dr Ste 6
Myrtle Beach, SC 29572-6733

Phone

(854) 237-5617

Fax

(854) 237-5618

NPI assigned

Oct 20, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: stacey.shaw.2@33134.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Charleston Counseling Center PC

  • Mental Health Counselor
  • Mount Pleasant, SC
  • NPI 1316375678
  Medicare reassignment NPD
• South Carolina Dept of Mental Health Accounting Office

  • Primary Care Nurse Practitioner
  • Bennettsville, SC
  • NPI 1295332690
  Medicare reassignment NPD
• River Region Psychiatry Associates LLC

  • Psychiatry Physician
  • Montgomery, AL
  • NPI 1386891497

  SC

  Medicare reassignment NPD
• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  SC

  Medicare reassignment
• Sondermind, P.a.

  • Clinical Social Worker
  • Wichita, KS
  • NPI 1710647581

  SC

  Medicare reassignment
• Myrtle Beach Counseling Center

  • Mental Health Counselor
  • Myrtle Beach, SC
  • NPI 1235784661
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1508457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781481600000",
    "number": "1093226789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 BRIARWOOD DR STE 6",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295726733",
            "telephone_number": "854-237-5617",
            "fax_number": "854-237-5618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 BRIARWOOD DR STE 6",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295726733",
            "telephone_number": "854-237-5617",
            "fax_number": "854-237-5618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "STACEY",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-20",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "SC",
            "license": "20127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tanya Shankar, MD
• Candice Elyse Shanklin
• Krishn Chris Sharma, MD
• Robin Michelle Shaver, PA
• Lataisha Shaw
• Briana Shea, LPC
• Kevin W Shea, MD
• Michael Jesse Shearer, DPT
• Amy M Sheets, LMT
• Amy Nicole Shelley, RN AND DOULA

• Psychiatric/Mental Health Nurse Practitioner in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Psychiatric/Mental Health Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.